patient care

ALSO NOTED: Telemedicine system links India, Ethiopia;KY county lets EMTs send patient data wirelessly; and much more...

Mon, 07 Apr 2008 06:59:50 -0400

> Here's an interesting telehealth project; a new pilot has linked hospitals in rural Ethiopia with India's leading cardiac institute. Article

> Officials in Louisville-Jefferson County, KY have bought a $2.1 million electronic patient care recording system that allows its EMTs to capture patient info digitally and wirelessly transmit the data to hospitals. Article

> A California medical practice is rolling out an EMR system with help from the National Committee for Quality Assurance. Article

> A California multi-site primary care and specialist network has set plans to offer patients a set of online administrative tools, including a PHR. Article

And Finally... Want to see what an EMR looked like circa 1961? Check this out. Video

SPOTLIGHT: How clinical IT is changing hospital care

Mon, 11 Feb 2008 06:59:52 -0500

In a recent blog post, hospitalist Dr. Bob Wachter says he continues to be impressed with the ways in which clinical IT is lending a hand in patient care, particularly when it comes to collecting information and sharing thoughts instantly through, say, text pages. However, in his mind clinical IT has also had some unexpected consequences which need to be considered, too. In particular, he worries that IT makes it too easy for clinical co-workers to isolate themselves, which can lead to breakdowns in communication and teamwork. Blog

Study: CIOs, IT vendors miles apart

Mon, 28 Jan 2008 06:59:56 -0500

A new study suggests that healthcare CIOs and software marketing executives are even father apart in their understanding of one another than you might think. The study, which surveyed 100 IT professionals and 100 vendor representatives, found that while a majority of vendors believe price is among the top factors in making a technology purchasing decision, only 44 percent of CIOs agreed. While 77 percent of CIOs considered functionality to be the most important criteria, vendors said that they felt functionality would rank equally with price as a key factor in such decisions, rating each at 57 percent.

Nor do the misunderstandings stop there. While 52 percent of vendor marketing chiefs said IT directors and managers were among the two most influential players in making IT purchases, and 31 named doctors and nurses, only 40 of CIOs said IT directors were key influencers, and a mere 17 percent said clinicians had that level of influence.

However, it appears that the two constituencies agree on one thing, the top challenges facing CIOs--communicating the business value of health IT investment to others within their organization, justifying their budget, building a business case for IT and communicating the impact of health IT on patient care.

To get more statistics from the study:
- read this Digital HealthCare & Productivity piece

Study: Nursing point-of-care IT can interfere with workflow

Mon, 07 Jan 2008 06:59:56 -0500

While hospitals buy it to increase patient safety and improve nurse productivity, some of the point-of-care technology they've implemented can sometimes interfere with bedside care, according to a new study. The study, conducted by Spyglass Consulting Group, concluded that facilities are making major clinical information systems investments, including both fixed and mobile devices and applications, designed to drive patient care data near to or at the point of care.

It's not as though point-of-care devices are all negative. The researchers, who interviewed more than 100 nurses, found 78 percent of nurses record their care at the patient's beside using IT applications, which saves time over recording data on paper and transferring it to electronic form. Nurses also find it helpful to record vital signs automatically for high-acuity patients, which can then be used immediately for nursing review and uploaded to EMRs.

However, some devices are difficult to move with, and may not maintain contact with the network as reliably as they ought to, the consulting firm found. Also, the devices need to be better integrated with broader systems, and their data synchronized more effectively with information from other relevant applications, before they can reach their full potential, the study suggested.

To get more data from the study:
- read this Modern Healthcare article (reg. req.)

Related Articles:
Physician mobile, wireless tech use jumps. Report
If we can tame the security issues, wireless IT is the future of medicine. Editorial
Case study: Nurses drive MSHA EMR project. Report
Study: Better health IT could give nurses more patient time. Report

Why RHIOs shouldn't exist

Mon, 10 Sep 2007 06:59:59 -0400

Without a doubt, there are a number of good reasons why RHIOs/HIEs should exist. Certainly, it can improve overall patient care if all of the providers a patient is likely to see have the same information. And sharing that information can save money if it avoids the need for duplicative tests or keeps patients from getting sicker than needed.

However, RHIO efforts keep getting swamped by legal issues (how do you handle the myriad of data sharing issues under HIPAA?), cost issues (the darned things are expensive!) and problems with the "coopetition" needed to get the job done? And how long can this model last if most efforts are paid for by grants? (see story below) Of course, the RHIO movement itself is in its infancy, but these are serious questions nonetheless.

Given these concerns, maybe it's time to take a contrarian position, and look at why RHIOs shouldn't exist. Maybe these aren't dealbreakers, but they aren't trivial problems either.

First, and perhaps most damning, the current model requires a level of trust among competitors that may simply be unrealistic. Opening up your network, on any level, is not a project for the faint-hearted. Sure, if you're a RHIO fan you can probably trot out examples of communities in which this has been overcome, but I'm betting that there's twice as many where lack of trust is stalling or even destroying connectivity efforts.

Another concern, of course, is cost. As an armchair IT observer, it's easy for me to say "you guys should just spend the money," but even I find it hard to justify the expense in my mind when there's so many other innovations (telemedicine for example) for which the ROI is much better demonstrated.

Still another issue is market readiness. Maybe RHIOs should exist, but other factors (widespread adoption of EMRs within health systems, most notably) should be in place universally before providers even consider a broader data exchange.

And what about potential flaws in the model itself? From my standpoint, some form of medical data banking--by a trusted intermediary rather than providers--seems to solve many problems that straight-ahead data exchanges can. That's one example of an alternate approach, and I'm sure there are others, which bypasses the existing data networking scheme entirely. What about Web-based PHRs, for example? Once they become more robust, they may solve many of the problems the more-expensive RHIOs want to address.

Hey, with my patient/consumer hat on, I certainly like the idea of data following me. I love the idea of my providers cooperating. But at the moment, I simply can't see how this kind of data sharing can work in the near future.

I know I'll probably get annoyed letters from RHIO backers for writing this, and that's OK, but it's probably beside the point. All I'm trying to say here is that before we fixate on RHIOs as the answer to patient data sharing, we should probably make sure we treat RHIOs and HIEs with all due skepticism. After, as you all know, once a network is in place it's hard to unring the bell.--Anne

Fla. researchers examine 11M records for drug effects

Mon, 27 Aug 2007 06:59:57 -0400

Working with anonymized claims data from 11 million Humana enrollees, University of Miami researchers will begin work on a study of unexpected drug interactions and dangerous prescribing practices. The project's approach isn't unusual, but this is one of the largest databases used in recent memory. What makes it more noteworthy is that the data analysis project mirrors what pharmaceutical firms are being pressured to do, but often aren't doing, with already-approved drugs.

Researchers working on the study will look at various factors that aren't always accounted for in pharmaceutical company studies, including patients having multiple illnesses, taking 10 plus drugs at a time, taking drugs incorrectly or failing to take them at all.

University of Miami physicians, who already have been using the data informally for about a year, released a study this week concluding stent-related heart attacks might be due to patients' stopping blood thinners too early.

To learn more about this project:
- read this article from the South Florida Sun-Sentinel

Related Articles:
FDA streamlining drug approval process. Report
FDA may boost experimental drug access. Report
Pharma firm post-marketing studies seen as inadequate. Report

Cerner does development with Missouri med school

Sun, 03 Jun 2007 20:01:36 -0400

The University of Missouri School of Medicine has struck a deal with a commercial sector giant, Cerner, to develop patient care and physician training tools. Among other projects, the two will work to enhance Cerner's EMR system to better address care of chronic conditions. The partners will also give patients access to a version of the EMR, and allow them to enter vital statistics such as weight, blood pressure or blood glucose levels into the system. Another joint project is to develop "virtual" patients for use in training. The new technology (which sounds pretty neat to your editor) would allow students to interact with virtual patients in unique ways, such as listening to the "patient's" heartbeat by putting their stethoscope to the monitor.

To learn more about the deal:
- read this piece in The Kansas City Star

Related Article:
New project enables the "house call of the future." Report

The self-aware hospital

Thu, 22 Feb 2007 09:21:30 -0500

Automated hospital asset tracking isn't a new idea. WiFi isn't a new idea. And of course, hospitals have always kept track of patients as they move through the system. But when you hit the HIMSS show floor, expect to see new solutions that integrate many of these elements into a large hospital ecosystem--one that starts at the ED door and extends across the hospital's assets, people, medication systems and more. These days, many solutions are being built around WiFi, linking asset tracking, patient tracking, pharmacy dispensing and more. I see the emergence, ultimately, of a "hospital operating system," one that goes well beyond IT integration efforts to an almost self-aware level.

It's difficult to characterize these technologies in a single sentence, as they range from systems that focus largely on RFID tagging to network analysis to others largely focused on keeping tabs on patients. For example, there's Emergin's nurse call and patient monitoring systems, which rest on a larger hospital IT integration platform. There are several vendors, such as Ekahau, Trapeze Networks, Versus and Aero Scout, that use WiFi to track not only traditional hard assets, but also equipment and/or people within the organization. But the bottom line, as always, is the patients, and simply tracking them is only part of the way. I'm going to ask vendors like these for some hard data as to how all of this might improve the patient care process, and I encourage you to do the same.

SPOTLIGHT: EHRs are important now, but just wait…

Sun, 17 Sep 2006 20:01:32 -0400

The American Medical Informatics Association last week issued a report that predicts efforts to access and use health care data for purposes unrelated to patient care are quite likely to grow as EHR adoption increases. Among other things, the report calls for a national framework for secondary uses of health information. As defined by the report, secondary use of health information includes: marketing and other commercial uses; payment; provider certification or accreditation; public health purposes; quality and safety measurement; and research. A national framework would ease "the broad and repeated collection, storage, aggregation, linkage and transmission of health data with appropriate protections for legitimate secondary use," the report states. Article

ALSO NOTED: Illinois hospital updates information system; MA medical groups launch eHealth plan; and much more...

Mon, 04 Sep 2006 20:00:36 -0400

> Illinois hospital updates patient care with electronic information system from Computer Programs and Systems. Article

> Massachusetts medical groups launch eHealth plan. Article

> Catholic Healthcare Partners to outsource tech operations. Article

> Army's Yokota clinic shifting to paperless records. Article

> Take forms processing to next level. Article

> InnerWireless healthcare customer receives award for adopting and applying innovative technologies. Item

And Finally... Push back on pushy vendors. Article